We mentioned on this blog a few weeks ago that the cost of Medicaid services continues to escalate here in Utah and across the nation. This upward trajectory is not expected to change anytime soon. Although we support the use of block grants to address the Medicaid status quo, an even better solution to addressing the needs of indigent and uninsured Utahns is the concept of authentic charity care.
Authentic charity care is “medical care provided to those in need without cost to the patient and without payment or government reimbursement to providers … [and] relies on the volunteer services of medical professionals and the voluntary contributions of private donors.”
The American hospital system was, at one time, primarily motivated by authentic charity care, which has since been diminished due to government regulation and welfare assistance. For Utahns, the benefits of authentic charity care would include a healthier population, a lesser tax burden over time, and a greater sense of community, generosity, gratitude and partnership among those who participate.
The Utah Legislature has passed two resolutions in support of authentic charity care. The first (in 2005) was a challenge to health care stakeholders to determine how an authentic charity care system could be administered, financed and coordinated to provide some healthcare services at a lower cost. The second (in 2010) recognized “authentic charity care as a key component of state health care policy” and urged communities, citizens and medical providers throughout Utah to support it.
Sutherland envisions the establishment of a state-chartered Community Health Foundation (CHF), which would institute a network of free health care clinics funded entirely through private donations. Each clinic would be staffed by volunteer health care workers who provide services to any resident of Utah. Those who receive care, or their families, would need to offer volunteer service or donations to give back to the community that assists them. In addition, authentic charity care services would be provided under the “Good Samaritan” law umbrella and therefore would not be open to any legal action.
This proposal may seem overwhelming to consider because it would require a substantial and sustained volunteer effort. However, Utah is first in the nation for volunteering. Each year, nearly 900,000 Utahns contribute $3.8 billion worth of volunteer services, which translates into nearly 90 hours of service per resident. Volunteerism is woven into the fabric of Utah society.
But would enough medical professionals volunteer to make authentic charity care work? Eleven percent of Utah’s volunteer service takes place in a hospital or the social service sector.
Furthermore, the number of physician assistants and nurses continues to increase in Utah, and we can head off the expected nationwide shortage in physicians and specialists by offering preventive medical services to Utah’s uninsured and implementing a number of other recommendations to address this issue.
The most significant evidence that charity care can work is the number of successful, free, donor-supported clinics already operating in Utah. The following established practices can serve as models for how to grow the network of service providers:
- The People’s Health Clinic inParkCity is a “volunteer-driven, community-supported nonprofit organization dedicated to providing quality health care to the uninsured in Summit and Wasatch Counties.” Established in 1999 by local medical practitioners and community members, this clinic now provides more than 7,000 patient visits annually through more than 100 dedicated volunteers and staff. The clinic is funded through private monetary and in-kind donations and through grants from private and family foundations. In the spirit of reciprocity, patients are encouraged to donate $15 per visit.
- The Doctors’ Volunteer Clinic of St. George recently expanded to better serve its 12,000 medical and dental patients. Because the clinic is a community-based, nonprofit organization and receives funding entirely through grants and donations, patients are asked to make a small $5 or $10 donation if they are able.
- The Volunteer Care Clinic in Provo provides basic health care services two evenings per week and is funded through the LDS Church, Intermountain Healthcare, and private donations.
- The Malileh Free Clinic of Salt Lake City provides free medical services for uninsured individuals and low-income families and is financed by the Semnani Foundation, private corporations, and individual donors. In addition, many volunteers offer their services to keep the clinic in operation.
Some people have expressed doubt that an authentic charity care network can meet the health care needs of all indigent Utahns. However, the state’s spirit of volunteerism, increasing numbers of health care professionals, and budding charity care efforts give us grounds to believe it is possible. Legislators, community leaders and healthcare providers need to rise to the challenge of the joint resolution and work together to create a robust, statewide authentic charity care network for the benefit of all Utahns.